Individual
JUNE ANN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
815 WEST CRAMER STREET, FORT ATKINSON, WI 53538
(920) 563-4957
Mailing address
815 WEST CRAMER STREET, FORT ATKINSON, WI 53538
(920) 563-4957
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4930-27
WI
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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